Evaluation of acute physiology and chronic health evaluation II system in a rural critical care setting: Correlating mortality and length of stay

BACKGROUND: Severity scoring systems are needed to assess quality of care, treatment efficacy, and may facilitate auditing and optimization of departmental resource utilization, with the aim of reducing health-care cost, providing better care, and improving outcomes. MATERIALS AND METHODS: The current retrospective study of 6 months' duration was performed to correlate Acute Physiology and Chronic Health Evaluation II (APACHE II) score with mortality and length of stay (LOS) in a seven bedded rural critical care setting, with 242 medical records of patients, admitted for 1 year. Demographic data, indication of intensive care unit (ICU) admission, and presence and absence of any chronic illness were obtained retrospectively from the patient records and documented in data collection form. At the completion of the first 24 h after the admission into ICU, APACHE II score was calculated using 12 physiological variables. Final outcome of the patient (shift out or death) and total length of critical care unit stay were recorded. RESULTS: In our study, the mean age of the patient was 38.5 +/- 1.05 ranging from 18 to 85 years, in whom 59.50% of patients had medical indications for ICU admission and increase in age was known to be associated with mortality (69.23%) in relation to APACHE II Score >34, and mean LOS in ICU was found to be 5.3 days +/- 0.36. CONCLUSION: APACHE II system will be of more priority in determining risk population for whom optimum care to be delivered, by which mortality in ICU could be minimized in rural critical care settings.